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US Senator Mike Rounds’ Weekly Column: Field Hearing Important Step to Fixing Indian Health Service

Field Hearing Important Step to Fixing Indian Health ServiceBy Senator Mike Rounds

I recently joined Senate Indian Affairs Committee Chairman John Barrasso and the other members of the South Dakota congressional delegation in a field hearing in Rapid City to discuss the inadequate health care being provided to our tribal members. The purpose of the hearing was to shed additional light on the ongoing crisis at Indian Health Service (IHS) facilities within the Great Plains Area, and to work with tribal leaders toward permanent solutions.

Nearly every week, if not every day, our newspaper headlines tell the tale of new problems with IHS facilities. It is important to understand the impact that IHS is having on real people on our tribal land. The Great Plains Area IHS, which covers South Dakota, North Dakota, Nebraska and Iowa, has the second highest mortality rate among all IHS regions. We also have the highest diabetes death rate, almost double the average among all IHS regions. Tragically, our life expectancy rate is also the lowest of all IHS regions, at 68.1 years. The U.S. average life expectancy is nearly a decade longer at 77.7 years. It is clear the IHS is failing our tribal members, who are suffering and in some cases even dying due to this inadequate and disgraceful care.

As we all know, Rosebud has essentially had its emergency department shut down for approximately 200 days and counting, meaning tribal members are having to drive over 50 miles to receive emergency care. The same is true for their obstetrics and surgical departments. These circumstances are going to continue to occur until we demand a thorough review and reform of IHS. More specifically, we need an external audit.

I had the opportunity to meet with the Great Plains Tribal Chairman’s Association in April. We discussed an in-depth profile analysis on IHS that my office put together in an attempt to seek answers and gain a better understanding. We talked about the administrative imbalance; of the 15,000 employees at IHS, only 750 are doctors and nearly 4,000 are administrative “medical billers.” We also found that IHS employees and administrators can’t explain or don’t understand their own budget.

After reviewing the data with me, the Great Plains Tribal Chairmen voted on a resolution supporting an audit of IHS. The IHS needs major reform but more taxpayer money won’t solve the dysfunction, because what IHS lacks is an efficient system and accountability. I appreciate Health and Human Services Acting Deputy Secretary Mary Wakefield’s support for an independent audit and look forward to working with her to get the answers necessary to turn the agency around. From my standpoint, investing more taxpayer money in a dysfunctional system will only compound the problem.

This is a serious issue that requires tangible solutions, not temporary fixes. There are significant administrative, financial and quality-of-care issues that must be addressed. The hearing helped us better understand where the problems lie so IHS, working in close collaboration with the tribes, can take steps forward to fix these problems. IHS will never be able to deliver the timely, quality care the federal government has a trust responsibility to deliver, without broad reforms.